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Safety and Efficacy of Imatinib Added to Chemotherapy in Treatment of Ph+ Acute Lymphoblastic Leukemia in Children

Phase 2
Completed
Conditions
Acute Lymphoblastic Leukemia
Philadelphia Chromosome
Interventions
Drug: Standard chemotherapy + Imatinib
Registration Number
NCT00287105
Lead Sponsor
Rennes University Hospital
Brief Summary

The purpose of this study is to determine whether Imatinib is safe and effective in association with intensive treatment of Ph+ALL in children.

Detailed Description

Recent advances in treatment have increased the cure of childhood ALL to 75% or better. However, attempts to improve results for resistant subtypes of ALL, such as Ph+ ALL, have been largely unsuccessful. Imatinib, an inhibitor of protein-tyrosine kinases, is currently being tested in several phase I, II and III trials covering most Chronic Myeloid Leukemia patient populations and patients with overtly relapsed or refractory Ph+ALL. Pediatric patients with Ph+ALL will receive Imatinib, added to intensive, post-induction BFM-type chemotherapy. The endpoint will be the evaluation on the long-term clinical outcome, in particular on the Disease Free Survival (DFS).

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
49
Inclusion Criteria
  • Children and adolescents aged 1 to 17 years at diagnostic
  • Documented Ph+ ALL
  • Eligibility for the current local prospective therapeutic study of childhood ALL
  • Informed consent given by the parents or by legal guardian
Exclusion Criteria
  • Abnormal hepatic functions
  • Abnormal renal functions
  • Active systemic bacterial, fungal or viral infection

Study & Design

Study Type
INTERVENTIONAL
Study Design
SINGLE_GROUP
Arm && Interventions
GroupInterventionDescription
Good risk Ph+ALLStandard chemotherapy + ImatinibFor protocols which adopt a steroid prephase: patients who are Prednisone-good responder and achieve CR after the induction course. For protocols which do not adopt steroid prephase: patients who have M1/M2 BM at day 15 or M1 BM at day 21 and achieve CR after the induction course. Expected stratification in this group: 70-75%.
Poor risk Ph+ALLStandard chemotherapy + ImatinibFor protocols which adopt a steroid prephase: patients who are Prednisone poor-responders. For protocol which do not adopt a steroid prephase: patients who have M3 BM at day 15 or M2/M3 BM at day 21. For all protocols: patients who do not achieve CR after the induction course. Expected stratification: 25-30%.
Primary Outcome Measures
NameTimeMethod
Disease free survival (DFS). DFS will be calculated as the time from inclusion to either one of the following events: relapse, death in CCR, second malignancies.2 years
Secondary Outcome Measures
NameTimeMethod
Compare long term outcome between patients treated by BFM-chemotherapy and patient undergoing more intensive chemotherapy (protocole COGAALL0031 : Children Oncology Group-USA).2 years
Long-term clinical outcome : Disease free survival (DFS), Event-Free Survival (EFS) and Overall Survival (OS) in each risk groups.2 years
Pattern of molecular response (MRD)5 time points between S4 and S22
Conversion rate to CR in patients resistant to the first part of the induction phase of chemotherapy included in the Poor-risk group.2 years

Trial Locations

Locations (22)

Service d'hémato-oncologie - Hôpital des Enfants Pellegrin

🇫🇷

Bordeaux, France

Limoges University Hospital

🇫🇷

Limoges, France

Service hématologie pédiatrique Hôpital Saint-Jacques

🇫🇷

Besancon, France

Hôpital Morvan

🇫🇷

Brest, France

Pédiatrie CHU - Hôpital Nord

🇫🇷

Grenoble, France

Hôpital Jeanne de Flandre

🇫🇷

Lille, France

Hématologie pédiatrique-Hopital américain

🇫🇷

Reims, France

Hématologie oncologie pédiatrique-CHU Caen

🇫🇷

Caen, France

Hématologie Hôpital Jean Bernard

🇫🇷

Poitiers, France

Service d'hématologie pédiatrique - Hôpital Sud

🇫🇷

Rennes, France

Service d'Immuno Hémato Oncologie Pédiatrique - Hôpital Charles Nicolle

🇫🇷

Rouen, France

Hôpital d'enfants

🇫🇷

Vandoeuvre Les Nancy, France

Hémato-Oncologie Pédiatrique - Hôpital d'Enfants

🇫🇷

Dijon, France

Hopital des enfants

🇫🇷

Toulouse, France

Hématologie Pédiatrique - Hôpital Trousseau

🇫🇷

Paris, France

Hôpital DEBROUSSE Institut d'hématologie et d'oncologie pédiatrique

🇫🇷

Lyon, France

Hémato-Oncologie et Thérapie Cellulaire Pédiatrique - Hôtel Dieu

🇫🇷

Clermont-Ferrand, France

Hôpital Arnaud de Villeneuve

🇫🇷

Montpellier, France

CHU- Centre Gatien de Clocheville

🇫🇷

Tours, France

Service d'hématologie pédiatrique CHRU

🇫🇷

Amiens, France

Hématologie, Oncologie pédiatrique-CHU Saint Etienne

🇫🇷

Saint Etienne, France

Hémato-immunologie-Robert Debré

🇫🇷

Paris, France

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